Trends and Clustering of Cardiovascular Health Metrics Among U.S. Adolescents 1988–2010

PURPOSE: American Heart Association recently published a set of seven cardiovascular (CV) health metrics for adults and children, emphasizing importance of preventing CV risk factors. Although CV disease risk factors have generally improved in adults, there is concern that this has not been true among adolescents. The present study examined trends and disparities of CV health metrics among U.S. adolescents. METHODS: We used data from a series of National Health and Nutrition Examination Survey (1988-1994, 1999-2004, and 2005-2010) including 11,233 adolescents aged 12-17 years. We estimated prevalence and mean score of CV health metrics and examined the disparities in mean score by sex, race/ethnicity, educational attainment, and poverty-income ratio. RESULTS: The prevalence of nonsmoking and healthy diet increased from 1988 through 2010, while the prevalence of normal body mass index and physical activity decreased, resulting in an unchanged distribution of overall CV health scores since 1988. The prevalence of adolescents meeting all seven CV health metrics was low, 3.5% (95% confidence interval [CI] 2.2-5.4), 4.0% (95% CI 3.3-4.8), and 4.0% (95% CI 2.9-5.3) in National Health and Nutrition Examination Survey 1988-1994, 1999-2004, and 2005-2010, respectively. The disparities in adjusted mean scores persisted between non-Hispanic whites and non-Hispanic blacks, families/households with >12 versus <12 years of education, and poverty-income ratio of >3 versus <3 (p < .05). CONCLUSIONS: The proportion of adolescents achieving all seven CV health metrics was low and remained unchanged during 1988-2010. The disparities in mean CV health score persisted among adolescents.